Individual
DALTON J ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6111 S 136TH CIR, OMAHA, NE 68137-4111
(402) 980-1970
Mailing address
6111 S 136TH CIR, OMAHA, NE 68137-4111
(402) 980-1970
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/11/2018
Last updated
11/11/2018
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